To reduce hospitalization and acute care visits for asthma among low income, African American children, this study will examine contribution of a peer counselor, from here forward called the Asthma Coach, to promote coordinated, preventive care for asthma and individual support for the parents, while specifically: 1. Encouraging reduced exposure to environmental tobacco smoke and cockroach allergen, major factors that exacerbate (or trigger) asthma; 2. Encouraging adherence to asthma management practices, including appropriate use of asthma medication. Specific Aim 1) Evaluate whether intervention by the Asthma Coach reduces episodes of severe asthma, as reflected in asthma hospitalizations and acute care visits (to either emergency departments (ED) or primary care offices), among low income, African American children recruited at time of hospitalization for asthma. Specific Aim 2) Evaluate whether intervention by the Asthma Coach reduces exposure to environmental tobacco smoke and cockroach allergen. Specific Aim 3) Evaluate whether intervention by the Asthma Coach increases other asthma management practices, including appropriate use of asthma medications and reported actions to reduce other environmental triggers, and improves quality of life of children and parent. Specific Aim 4) Assess the combination of intervention by the Asthma Coach and exposure to a neighborhood based asthma management and education program, the Neighborhood Asthma Coalition.